In their latest article for The Legal Intelligencer, Managing Partner Sam Pond and Associate Susan Nanes expose the underpinnings of the recently proposed House Bill 18 (HB-18), another in a long line of legislative “reforms” to workers’ compensation sponsored by Pennsylvania Representative Ryan Mackenzie (R‐134). A Trojan Horse masquerading as an attempt to reduce opiate usage, HB-18 would ultimately allow insurance companies to profit at the expense of injured workers’ pain, suffering, and decreased quality of life.
The bill’s provisions would allow insurance companies to control the medical care of injured workers by mandating a specific drug list of “acceptable” medicines, or a formulary, that severely limits doctors’ ability to prescribe necessary medications, thus preventing workers from receiving the treatment they need to get better.
“If a medication is on the list, it can be prescribed as usual,” Sam and Susan explain. “If not, the doctor and patient must either select an acceptable alternative or go through red tape and the usual presumptive ‘no’ in order to get approval for the prescription. It is unknown how long the injured worker may have to wait. In that time, the worker may have to make do with ineffective substitutes, and the injury or condition may worsen for lack of proper care. This is unacceptable in any context, and more so when it is a worker injured on the job. Pain does not wait for paperwork. Most importantly, although touted as a remedy for the opioid crisis, HB-18 applies to all medications, not just opioids.”
The article also explores the source of the treatment data used as evidence to support HB-18. The Workers’ Compensation Research Institute (WCRI), while positioned as an independent, not-for-profit research organization, has a member list composed largely of employers, service providers and insurers. “It is a stretch to see the WCRI as a diverse and evenhanded collection of equal stakeholders.” The article elaborates, “It seems more like the ‘research institutes’ that the tobacco industry set up to sell their propaganda for decades. Needless to say, the ‘independence’ of the WCRI should be considered in light of its membership. It is hard to conjure a group of entities more in tune with the Wall Street Journal than with the concerns of injured workers.”
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